Planned parenthood 2026

1. Click ‘Get Form’ to open the enrollment form in the editor.
2. Begin by entering your Date of Birth (DOB) in the designated field. This information is crucial for your enrollment.
3. Fill in your full name and mailing address for refills, ensuring that it is located within North Carolina, as this is a requirement for shipping.
4. Provide a telephone number where you can be reached for any questions related to your order.
5. Select your payment method by circling either Visa or Mastercard. Enter your card number, expiration date, and CV2 data accurately.
6. Authorize the charges by writing the amount you agree to pay each time your birth control method is mailed, plus $1.00 for shipping.
7. Sign and date the form at the bottom to complete your enrollment process.

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